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Table 2 Focus group themes: Factors affecting recruitment and retention

From: Retention of allied health professionals in rural New South Wales: a thematic analysis of focus group discussions

Theme “Push” factor (leave job) “Pull” factor (recruit/retain in job)
Personal factors: Lack of job opportunities for spouses  
Perceived inadequate quality of secondary schools Attraction to rural lifestyle
Care for elderly parents Good place to raise children
Retirement Married to a local resident
Family members living in a metropolitan area Rural origin/family in area
For younger AHP’s: Low cost of living
Limited social opportunities Personal engagement in the community
Desire for adventure/travel  
Career progression: Better career opportunities in metropolitan settings NSW Health Award structure (accelerated promotion for new graduates in rural practice settings)
Lower income, smaller market for rural private practitioners Recognition by peers and others
Rural senior positions unavailable or not open for recruitment Advanced work roles
  Appropriate remuneration
Workload and type of work: Unmanageable workload Altruism, making a difference
Crisis mode of service, reactive not preventive Direct individual patient care
Paperwork, reporting requirements Generalist practice with advanced work roles - ‘specialist generalist’
  Challenge, variety and intellectual stimulation embedded in the job
Continuing Professional Development (CPD): Limited access to CPD due to: University campus in regional centres increases CPD access
Lack of management support to attend CPD events Access to CPD:
Cost of travel ameliorates professional isolation
Expensive registrations (metropolitan courses) is strongly linked with job satisfaction
Time away from work is essential for new graduates and isolated practitioners
High workload demands Assures that senior clinicians skills remain up to date
  Provides intellectual challenge and opportunities for career progression
The impact of management: Perceived inequitable or inappropriate resource allocation Supportive line managers
Nurse managers Support for CPD access
Failure to recruit vacant positions Clinical mentorship for new graduates
Constant change Flexible work hours
Managers who are unresponsiveness to suggestions Autonomy
Feeling de-valued Equitable resource allocation sufficient to deliver clinical services
Ethical compromise – fiscal vs. clinical imperatives Realistic estimate of workload capacity
  Move to private practice to escape public sector “management